NPIMap

Individual provider Active NPI

Mohammed A Wazzan

  • Clinical Cardiac Electrophysiology Physician
  • Colonial Heights, VA
National Provider Identifier
1588112759
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
0101282893 Issued in VA
Practice address
445 Charles H Dimmock Pkwy Ste 100
Colonial Heights, VA 23834-2990
Phone
(804) 520-1764
NPI assigned
Sep 16, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 0101282893 VA
Internal Medicine Physician 207R00000X 0101282893 VA
Clinical Cardiac Electrophysiology Physician 207RC0001X 0101282893 VA Primary

Addresses

Primary practice location

445 Charles H Dimmock Pkwy Ste 100
Colonial Heights, VA 23834-2990

Mailing address

445 Charles H Dimmock Pkwy Ste 100
Colonial Heights, VA 23834-2990
Phone (804) 520-1764

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240821001504 VA Practitioner - Cardiac Electrophysiology 3678011699 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac Electrophysiology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
James River Cardiology, LLCGroup PAC ID 0941499594, 49 clinicians

Practice addresses (Care Compare)

445 Charles H Dimmock Pkwy
Suite 100
Colonial Heights, VA 23834-2990
Phone (804) 520-1764

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
James River Cardiology, LLC Cardiovascular Disease CurrentSince Aug 1, 2024 Accepting new patients
Chippenham & Johnston-Willis Hospitals, Inc. CurrentSince Dec 7, 2024 Accepting new patients
Columbia/HCA John Randolph, Inc. Cardiovascular Disease CurrentSince Jan 25, 2025 Accepting new patients
Chippenham & Johnston-Willis Hospitals, Inc. Current Accepting new patients

Locations

89 Sherwood Dr
Colonial Hgts, VA 23834
Phone (804) 526-3010

445 Charles H Dimmock Pkwy
Ste 100
Colonial Hgts, VA 23834

411 W Randolph Rd
Hopewell, VA 23860
Phone (804) 452-3624

7101 Jahnke Rd
Richmond, VA 23225
Phone (804) 323-1088

8006 Discovery Dr
Ste 300
Richmond, VA 23229
Phone (804) 495-2299

8006 Discovery Dr
Ste 130
Richmond, VA 23229
Phone (804) 495-2299

8006 Discovery Dr
Ste 120
Richmond, VA 23229
Phone (804) 495-2299

Interoperability endpoints

  • Direct secure messaging: mwazzan38588@ehrdirect.uhhospitals.org
  • Direct secure messaging: mohammed.wazzan.1@31267.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1473984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1588112759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 CHARLES H DIMMOCK PKWY STE 100",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238342990",
            "telephone_number": "804-520-1764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 CHARLES H DIMMOCK PKWY STE 100",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238342990",
            "telephone_number": "804-520-1764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAZZAN",
        "first_name": "MOHAMMED",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-16",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0101282893",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101282893",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "VA",
            "license": "0101282893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colonial Heights, VA

Sources for this page

Verify at the official NPI Registry.